Nasopharyngeal non-Hodgkin lymphoma
Referral to ENT from GP following concerns of a nasopharyngeal carcinoma.
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Large bilateral nasopharyngeal mass extending, more so on the left, into the oropharynx.
Histology - NASOPHARYNGEAL BIOPSY
The biopsy shows a malignant lymphoma composed of sheets of atypical lymphoid cells infiltrating the fibrous and vascularised connective tissue stroma. The cells exhibit enlarged nuclei wih abnormal chromatin, some with prominent nucleoli ans scanty neoplasm.
The cells are strongly positive for LCA,CD20cy, CD79a.
Conclusion: Malignant non-hodgkin lymphoma - B cell type
The vast majority of nasopharyngeal masses are squamous cells carcinomas. The second commonest cause, albeit infrequent, cause of a primary nasopharyngeal malignancy is lymphoma.
Symmetrical lymphoid tissue normally exists in the nasopharynx, as Waldeyer's ring, in which a primary lymphoma may develop. Other sites in the locality include the tonsils.